| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $200.88 | $200.88 | $200.88 | |
Aetna
| Professional | $107.21 | $154.97 | $200.88 | |
Cigna
| Facility | $147.10 | $147.10 | $147.10 | |
Cigna
| Professional | $107.38 | $125.04 | $151.51 | |
United
| Professional | $7.86 | $12.09 | $31.79 |